| Project/Area Number |
06671530
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Anesthesiology/Resuscitation studies
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| Research Institution | Yamaguchi University |
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Principal Investigator |
TATEISHI Akio Yamaguchi Univ.Hospital Assistant Professor, 医学部・附属病院, 助教授 (00155102)
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| Co-Investigator(Kenkyū-buntansha) |
NAKASHIMA Ken Yamaguchi Univ.Hospital Research Associate, 医学部・附属病院, 助手 (00243668)
FUJISAWA Hirosuke Yamaguchi Univ.School of Med.Research Associate, 医学部, 助手 (50238565)
SADAMITSU Daikai Yamaguchi Univ.School of Med.Assistant Professor, 医学部, 助教授 (10187164)
MAEKAWA Tsuyoshi Yamaguchi Univ.School of Med.Professor, 医学部, 教授 (60034972)
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| Project Period (FY) |
1994 – 1995
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| Project Status |
Completed (Fiscal Year 1995)
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| Budget Amount *help |
¥2,100,000 (Direct Cost: ¥2,100,000)
Fiscal Year 1995: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1994: ¥1,500,000 (Direct Cost: ¥1,500,000)
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| Keywords | Cerebral resuscitation / Post-resuscitation encephalopathy / Head trauma / Microdialysis / Lactate / Nitric Oxide / Excitatory amino acid |
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| Research Abstract |
Purpose ; to clinically introduce several biochemical indices, in addition to conventional electrophysiological monitoring, and thereby to detect the derangement of neural metabolic process upon which newly-developed therapies are to be focused.
Subjects ; hypoxic encephalopathy, subarachnoid hemorrhage, head trauma (15 patients).
Methods ; In hypoxic encephalopathy, oxygen saturation and lactate concentration in the jugular bulb blood were measured to assess the presence of anaerobic oxygen metabolism during relative hypoperfusion phase immediate post-resuscitation. In subarachnoid hemorrhage (SAH) complicated with cerebral vasospasm, the effect of mild hypothermia on excitotoxicity process was evaluated by measuring glutamate (Glu ; HPLC) and nitric oxide (NO2, NO3 ; capillary electrophoresis) levels in cerebrospinal fluid (CSF). In severely head-injured patients, Glu and NOx levels are measured in microdialysis perfusate.
Results ; The concentration of lactate was greater in both arter
… More
ial and venous blood in non-survivors than in survivors. The arteriovenous difference of lactate was, however, not statistically different between survivors and non-survivors. The CSF Glu level was elevated early post-SAH ; Glu was decreased by inducing mild hypothermia (33-35 degree C). The elevated NOx level was not influenced by hypothermia. In a head-injured patient in whom microdialysis probe was inserted, perfusate NOx was increased 1-2 hours in advance to peaks of intracranial pressure changes.
Discussion ; Sampling extracellular fluid with a microdialysis technique is superior to venous blood or CSF sampling for obtaining information regarding intracranial metabolic environment, although large molecules can not be dialyzed. Decreases in CSF Glu might represent the inhibitory effect of mild hypothermia upon excitotoxic process. NOx may be included in the development of traumatic brain injury, in which microdialysis method will be a promising real-time monitor for pathophysiologic process. Less
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